SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey ... more SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey of factors influencing decision-making in relation to antipsychotic, antidepressant and mood stabilizer prescribing. The acceptance of such a survey is in itself a positive result. In the current climate of evidence based medicine and guidelines, preliminary results from this survey suggest that, when asked regarding treatment choice for themselves, psychiatry trainees preferred second-generation atypical antipsychotic medication, based on perceived efficacy. The results for mood stabilisers were less striking. The relevance of this survey, in the context of recent evidence, may relate to trainees’ perceptions as opposed to evidence base.
IntroductionBurnout syndrome is defined by three domains: emotional exhaustion, cynicism and redu... more IntroductionBurnout syndrome is defined by three domains: emotional exhaustion, cynicism and reduced professional efficacy. Junior doctors have a high susceptibility to burnout reflected in the high prevalence identified in previous work. This is a significant issue as burnout has measurable effects on work performance. There has been limited research conducted on burnout in psychiatry trainees in the United Kingdom.AimThis paper takes a step towards addressing this gap by extracting the data concerning UK psychiatric trainees collected in the international burnout syndrome study (BoSS), which aimed to assess the prevalence and contributing factors of burnout among psychiatric trainees from over 20 countries, and presenting the findings concerning UK trainees.MethodData collected included demographic data and information related to working hours, bullying, harassment and stalking, supervision, suicidal ideation, depression (PHQ−9), and a personality trait assessment. Burnout syndrom...
IntroductionThe international burnout syndrome study (BoSS) examined burnout in psychiatry traine... more IntroductionThe international burnout syndrome study (BoSS) examined burnout in psychiatry trainees and associated factors. Long working hours were significantly associated with burnout.AimsA high rate of severe burnout in UK psychiatric trainees (38%) was found in the BoSS study. This paper looks at the working hours of UK trainees.MethodsData collected during the BoSS study included information related to working hours, looking in particular at the working time directive rules. A total of 3964 UK psychiatric trainees were invited to take part, of which 1187 (30%) responded, and 811 (20%) provided complete responses for working hours questions.ResultsThe mean age was 33 years, with 49.1% males and equal gender distribution of participants and non-participants. The mean hours of contracted work per week were 42.7 (42.2–43.2) for men, versus 41.1 (40.4–42.0) for women. Actual hours worked were significantly higher at 46.2 (45.0–47.4) for men and 46.0 (44.9–47.1) for women. Forty-six ...
International Journal of Social Psychiatry, Mar 1, 2009
This study aims to evaluate the psychological and career-planning impact of the new postgraduate ... more This study aims to evaluate the psychological and career-planning impact of the new postgraduate training system Modernising Medical Careers (MMC) on junior doctor applicants in the UK. We hypothesized that certain junior doctor groups were more vulnerable to distress during the process than others. Online, anonymous, cross-sectional attitudes survey of applicants in June 2007. Participants were Medical Training Application System (MTAS) applicants of all grades in the UK. Of 1,002 responders, 703 (70%) reported four or more depressive symptoms; 231 (23%) reported increased suicidal thinking; 932 (93%) increased stress; 856 (85%) increased worry; 374 (37%) consumed more alcohol. Some 941 (94%) attributed increased stress to ;MMC/MTAS'. Female sex (OR = 1.48, 95% CI = 1.12, 1.95) and not receiving a job offer (OR = 1.85, 95% CI = 1.35, 2.56) predicted higher number of depressive symptoms. At the onset of MMC, MTAS applicants reported negative process experiences, psychological distress and poor coping (including increased alcohol use), with possible implications for mental health, career planning and patient care.
BackgroundPostgraduate medical trainees experience high rates of burnout, but evidence regarding ... more BackgroundPostgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout.MethodsIn an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout.ResultsThis is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8–65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (P ...
Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatri... more Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout.
Why take a year Out of Programme (OOP) in South Africa (SA)? Rural hospitals and primary care fac... more Why take a year Out of Programme (OOP) in South Africa (SA)? Rural hospitals and primary care facilities in SA and other developing countries have a significant need for doctors and allied health care professionals. This is due to numerous well-described push factors, such as ...
Introduction: Guernsey is a British Protectorate island (population 65000) in the English Channel... more Introduction: Guernsey is a British Protectorate island (population 65000) in the English Channel. Illicit drugs are difficult to import and expensive people look to alternative substances. Objectives: To establish patterns of drug misuse among patients referred for treatment. Methods: Case note audit of all referred patients in 2011, cross referenced with sudden unexpected death case review results. Results: 198 patients were referred, 80 (40%) for mainly drug dependency. Reported patterns of use tended to follow local availability and polydrug misuse was common. Of the drugs clients, 96% reported misusing prescription only medicines (POMs) and over the counter (OTC) drugs, particularly opiates and benzodiazepines. Buprenorphine products were most commonly misused (26%), followed by benzodiazepines (25%), dihydrocodeine (22%), heroin (11%) and codeine (6%) (more than 1 drug may be reported so totals <100%). A high risk sub-group (9%) injecting fentanyl (derived from fentanyl patches) was identified. On the island in 2011 there were several fentanyl-related deaths at post mortem case review. Conclusions: High rates of pharmaceutical drug misuse on Guernsey may reflect the low availability of illicit drugs like heroin and cocaine. This increases demand for addictive POMs and OTCs. Prescribers in isolated communities need to be more cautious when prescribing addictive POMs, particularly fentanyl. Pharmacists may also need to monitor for OTC drug misuse, particularly of codeine-containing medications.
The aim of this paper is to systematically review the literature available internationally on rec... more The aim of this paper is to systematically review the literature available internationally on recruitment into psychiatry. A 5-stage search strategy was followed to identify all relevant studies published between 1999-2012. These were then critically appraised using a standardized tool, and the results summarized. A total of 128 studies were identified. Surveys were the most common design (40%), and 76% of studies used medical students as subjects; 36% of the studies were from the USA, followed by 25% from the UK. There were no studies found from South America. There is a need for more research into other potential applicant groups before medical school, and for research carried out in Africa, Asia and South America.
Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health t... more Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health treatment in many countries worldwide. We attempt to address this burning issue by examining medical student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s attitudes towards psychiatry and factors influencing their career choice in the Czech Republic. In 2010, 71 students in their last year of medical school at the First Faculty of Medicine, Charles University, Prague were recruited in this quantitative cross-sectional online study. From the sample, 16% (n = 11) of students were considering psychiatry as a career path. An important factor in choosing psychiatry as a career path was personal/family presence of mental illness. Longer experience with psychiatry placement also contributed to the choice of psychiatry, as well as participation in elective courses or psychiatric research projects. Students considering psychiatry were less systematic compared to the group not considering psychiatry. Low reported levels of recruitment to psychiatry present a problematic issue in the Czech Republic. To make psychiatry more appealing to medical students, proactive steps by the relevant stakeholders need to be implemented. These strategies should include steps such as allocating more time for psychiatry in the medical curriculum, better quality of lectures, and the inclusion of additional elective courses.
SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey ... more SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey of factors influencing decision-making in relation to antipsychotic, antidepressant and mood stabilizer prescribing. The acceptance of such a survey is in itself a positive result. In the current climate of evidence based medicine and guidelines, preliminary results from this survey suggest that, when asked regarding treatment choice for themselves, psychiatry trainees preferred second-generation atypical antipsychotic medication, based on perceived efficacy. The results for mood stabilisers were less striking. The relevance of this survey, in the context of recent evidence, may relate to trainees’ perceptions as opposed to evidence base.
IntroductionBurnout syndrome is defined by three domains: emotional exhaustion, cynicism and redu... more IntroductionBurnout syndrome is defined by three domains: emotional exhaustion, cynicism and reduced professional efficacy. Junior doctors have a high susceptibility to burnout reflected in the high prevalence identified in previous work. This is a significant issue as burnout has measurable effects on work performance. There has been limited research conducted on burnout in psychiatry trainees in the United Kingdom.AimThis paper takes a step towards addressing this gap by extracting the data concerning UK psychiatric trainees collected in the international burnout syndrome study (BoSS), which aimed to assess the prevalence and contributing factors of burnout among psychiatric trainees from over 20 countries, and presenting the findings concerning UK trainees.MethodData collected included demographic data and information related to working hours, bullying, harassment and stalking, supervision, suicidal ideation, depression (PHQ−9), and a personality trait assessment. Burnout syndrom...
IntroductionThe international burnout syndrome study (BoSS) examined burnout in psychiatry traine... more IntroductionThe international burnout syndrome study (BoSS) examined burnout in psychiatry trainees and associated factors. Long working hours were significantly associated with burnout.AimsA high rate of severe burnout in UK psychiatric trainees (38%) was found in the BoSS study. This paper looks at the working hours of UK trainees.MethodsData collected during the BoSS study included information related to working hours, looking in particular at the working time directive rules. A total of 3964 UK psychiatric trainees were invited to take part, of which 1187 (30%) responded, and 811 (20%) provided complete responses for working hours questions.ResultsThe mean age was 33 years, with 49.1% males and equal gender distribution of participants and non-participants. The mean hours of contracted work per week were 42.7 (42.2–43.2) for men, versus 41.1 (40.4–42.0) for women. Actual hours worked were significantly higher at 46.2 (45.0–47.4) for men and 46.0 (44.9–47.1) for women. Forty-six ...
International Journal of Social Psychiatry, Mar 1, 2009
This study aims to evaluate the psychological and career-planning impact of the new postgraduate ... more This study aims to evaluate the psychological and career-planning impact of the new postgraduate training system Modernising Medical Careers (MMC) on junior doctor applicants in the UK. We hypothesized that certain junior doctor groups were more vulnerable to distress during the process than others. Online, anonymous, cross-sectional attitudes survey of applicants in June 2007. Participants were Medical Training Application System (MTAS) applicants of all grades in the UK. Of 1,002 responders, 703 (70%) reported four or more depressive symptoms; 231 (23%) reported increased suicidal thinking; 932 (93%) increased stress; 856 (85%) increased worry; 374 (37%) consumed more alcohol. Some 941 (94%) attributed increased stress to ;MMC/MTAS&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;. Female sex (OR = 1.48, 95% CI = 1.12, 1.95) and not receiving a job offer (OR = 1.85, 95% CI = 1.35, 2.56) predicted higher number of depressive symptoms. At the onset of MMC, MTAS applicants reported negative process experiences, psychological distress and poor coping (including increased alcohol use), with possible implications for mental health, career planning and patient care.
BackgroundPostgraduate medical trainees experience high rates of burnout, but evidence regarding ... more BackgroundPostgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout.MethodsIn an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout.ResultsThis is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8–65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (P ...
Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatri... more Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout.
Why take a year Out of Programme (OOP) in South Africa (SA)? Rural hospitals and primary care fac... more Why take a year Out of Programme (OOP) in South Africa (SA)? Rural hospitals and primary care facilities in SA and other developing countries have a significant need for doctors and allied health care professionals. This is due to numerous well-described push factors, such as ...
Introduction: Guernsey is a British Protectorate island (population 65000) in the English Channel... more Introduction: Guernsey is a British Protectorate island (population 65000) in the English Channel. Illicit drugs are difficult to import and expensive people look to alternative substances. Objectives: To establish patterns of drug misuse among patients referred for treatment. Methods: Case note audit of all referred patients in 2011, cross referenced with sudden unexpected death case review results. Results: 198 patients were referred, 80 (40%) for mainly drug dependency. Reported patterns of use tended to follow local availability and polydrug misuse was common. Of the drugs clients, 96% reported misusing prescription only medicines (POMs) and over the counter (OTC) drugs, particularly opiates and benzodiazepines. Buprenorphine products were most commonly misused (26%), followed by benzodiazepines (25%), dihydrocodeine (22%), heroin (11%) and codeine (6%) (more than 1 drug may be reported so totals <100%). A high risk sub-group (9%) injecting fentanyl (derived from fentanyl patches) was identified. On the island in 2011 there were several fentanyl-related deaths at post mortem case review. Conclusions: High rates of pharmaceutical drug misuse on Guernsey may reflect the low availability of illicit drugs like heroin and cocaine. This increases demand for addictive POMs and OTCs. Prescribers in isolated communities need to be more cautious when prescribing addictive POMs, particularly fentanyl. Pharmacists may also need to monitor for OTC drug misuse, particularly of codeine-containing medications.
The aim of this paper is to systematically review the literature available internationally on rec... more The aim of this paper is to systematically review the literature available internationally on recruitment into psychiatry. A 5-stage search strategy was followed to identify all relevant studies published between 1999-2012. These were then critically appraised using a standardized tool, and the results summarized. A total of 128 studies were identified. Surveys were the most common design (40%), and 76% of studies used medical students as subjects; 36% of the studies were from the USA, followed by 25% from the UK. There were no studies found from South America. There is a need for more research into other potential applicant groups before medical school, and for research carried out in Africa, Asia and South America.
Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health t... more Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health treatment in many countries worldwide. We attempt to address this burning issue by examining medical student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s attitudes towards psychiatry and factors influencing their career choice in the Czech Republic. In 2010, 71 students in their last year of medical school at the First Faculty of Medicine, Charles University, Prague were recruited in this quantitative cross-sectional online study. From the sample, 16% (n = 11) of students were considering psychiatry as a career path. An important factor in choosing psychiatry as a career path was personal/family presence of mental illness. Longer experience with psychiatry placement also contributed to the choice of psychiatry, as well as participation in elective courses or psychiatric research projects. Students considering psychiatry were less systematic compared to the group not considering psychiatry. Low reported levels of recruitment to psychiatry present a problematic issue in the Czech Republic. To make psychiatry more appealing to medical students, proactive steps by the relevant stakeholders need to be implemented. These strategies should include steps such as allocating more time for psychiatry in the medical curriculum, better quality of lectures, and the inclusion of additional elective courses.
Uploads
Papers by Gregory Lydall